The paper analyses how the Covid-19 pandemic affected young people’s alcohol-related assemblages, trajectories of becoming and identity claims in Sweden. The data is based on longitudinal qualitative interviews among heavy and moderate drinking young people (n = 23; age range 15–24 years). The participants were interviewed two to three times before the Covid-19 pandemic and once at the end of it, between 2017 and 2021. The analysis draws on actor-network theory and narrative positioning approach. The analysis demonstrates how the lockdown produced trajectories of becoming boring, normal, stress-free, self-caring, self-confident and shielded. In these trajectories, drinking was positioned into relations that either increased young people’s capacities for well-being or decreased them. Due to the lockdown, some participants learnt to be moved by relations that contributed to replace drinking with competing activities, while others experienced that the lockdown made drinking a more attractive activity, turning it into a collective force that helped them to overcome isolation. The results show how drinking is a heterogeneous activity which may increase or decrease young people’s capacities for well-being, depending on what kinds of assemblages and trajectories of becoming it is embedded in.

In this article, we analyze the care work employed by people who inject drugs to counter risks in their life situations and make their drug use safer. Injecting drugs is associated with numerous health and social risks, such as overdose, the use of used and shared equipment, and getting caught by the police. We approach descriptions of injection events as narratives of care. Participants (N=32) were recruited for semi-structured interviews primarily from the Stockholm Needle and Syringe Exchange Program between August 2022 and March 2023. The sample is heterogeneous in terms of age, gender, drug use, and social situation. The interviews were analyzed using actor-network theory, asking what kind of care work and ‘action programs’ strengthen or weaken participants' capacities for safer injection events and what kinds allow risks – or antiprograms – to enter the event. We identified four different action programs based on home or public settings. They all aimed to increase capacities for safe drug use, but two of them were more vulnerable to risks. Their success depended on the type of actors they could recruit for care work, the risks they were targeting, and how well they coordinated actors to work together to minimize risks. The analysis highlights the scope, strengths, and limitations of care work in relation to material, social, political, and institutional actors, as well as the importance of access to proper resources such as a home, stable income, and a healthy body.

Intrigued by the overwhelmingly positive response to the needle and syringe exchange program (NSP) by people who inject drugs in Stockholm, this article sought to untangle harm reduction in a prohibitionist drug policy context. The article drew on assemblage thinking and used semistructured individual interviews with 32 people who inject drugs, and three focus groups with staff at the Stockholm NSP. The aim was to dissect harm reduction in the form of NSP and how it worked to move people who inject drugs towards or away from drug-related harm. The analysis identified how bodies such as the NSP regulations, the setting, and stigma gathered in ways that reduced the capacity to move forward and enroll, as the inclusion of the NSP in the assemblage would decrease the capacity to uphold other connections considered to be more important. Regular NSP visitors however described how free injecting equipment, staff care, continuity, and trust were important objects that gathered in ways opening up for movement towards less harm. Fiercely, these profoundly caring experiences at the NSP could also block new becomings and moves forward as people who inject drugs, discouraged from previous negative experiences of other service providers and structural stigma, refrained from other connections that could improve their wellbeing. They risked becoming locked in at the NSP and similar services. A significant consequence of the agential cuts of us researchers, the staff, and policymakers alike, targeting primarily those that do access and benefit from harm-reducing interventions, is that alternative solutions embracing also those locked out and locked in become unimaginable.

Background. Drug policy is prone to build on rationales based on different moralities rather than evidence. Less is known about how moralities influence drug policy implementation in practice. The aim was to analyze expressions of moralities among local policy-makers, professionals, and drug users in the context of the Stockholm needle and syringe exchange program (NSP).

Methods. Using political documentation from Stockholm (2003–2016), focus group (12 NSP staff), and 32 drug user interviews, moralities concerning drug policy and harm reduction were analyzed based on moral foundations theory and boundary work.

Results. Three main moral dilemmas were identified concerning the subjects, aims, and orientation of drug policy: whether drug users are worthy of inclusion to society; if the general public should be prioritized or the health of drug users, and the orientation of practices as based on control or autonomy. Policy debate was driven by virtues such as purity and authority, whereas staff and drug users valued care, fairness and liberty.Conclusions. The prohibitionist and abstinence-oriented Swedish drug policy has created social boundaries on the practice-level. Hence, users’ perspectives, and those who care about them, should be extensively involved in political discussions to foster a more moral and humane drug policy.

Background: By contrasting the approaches of neutralization theory (NT) and actor-network theory (ANT), we argue that research using NT can contribute to stigmatizing people with substance use problems as ‘liars,’ ‘irresponsible,’ and ’incapable.’ In contrast, ANT can help us become more sensitive to the participants’ realities and produce non-stigmatizing results. Methods: The data consists of 22 life stories in which participants describe the concerns their substance use caused for their parenting and how they addressed them. With ANT, we analyze what kinds of mediators in our participants’ parenting assemblages increased or decreased their capacities to mitigate the negative effects of substance use on their children. Results: In our analysis, we identified four parenting assemblages. The assemblages of ‘displacing substance use’ and ‘keeping up ordinary family life’ increased the participants’ capacities to move substance use away from encounters with children or to use it to strengthen their engagement with everyday life parenting practices. The assemblages of ‘losing oneself to the dominance of substances’ and ‘being moved by a traumatic past’ decreased the participants’ parenting capacities by weakening their connections to good enough parenting, or by allowing the connections from the past to dominate and mediate their present action, leading to relapse in drug use and the loss of a child. Conclusion: Our study suggests that by shifting the perspective from doubt and criticism (NT) to empathy and care (ANT), research can transcend mere critique and serve as a tool for empowerment, advocacy, and meaningful change.

Aim: This article examines how Swedish parents navigate the multifaceted challenges of parenthood while struggling with substance use problems, including both alcohol and illicit drugs, and societal stigma. It explores how parents present themselves as responsible caregivers while distinguishing between acceptable and harmful substance use in the context of parenting. Methods: The study uses data from unstructured 15 life story interviews, conducted over the phone or Zoom. The participants narrated their life stories related to substance use problems, covering various topics like education, relationships, and parenting. The interviews were analyzed using thematic analysis to reveal strategies used by participants to mitigate perceived harm from substance use problems, enabling them to present themselves as responsible parents. Results: Three main themes were identified: Hiding, compensating, and disappearing, focusing on time and place. The analysis shows that Swedish parents manage parenthood with substance use problems and societal stigma by concealing substance use problems and maintaining a ‘façade of normality’, often scheduling use when children are asleep. Some resort to hiding substances to create the illusion of moderation. Despite challenges, like needing alternative locations for substance use problems, parents emphasize active engagement in their children’s lives. Conclusion: This study highlights how parents with substance use problems navigate parenthood amid societal stigma, revealing their strategies and challenges. These insights are vital for healthcare professionals and policymakers crafting support interventions to address parental experiences and associated emotional burdens.

Background: Reducing risks and harms among people who inject drugs by, for example, Needle and Syringe exchange Programs (NSP) may be impeded in practice by, for example, policy restrictions, particularly in settings like Sweden where a zero-tolerance drug strategy prevails. In practice, risks and harms are produced through an interplay of multiple mutually reinforcing factors. Moreover, risk management strategies may constitute risks per se and generate new risks, potentially intensifying overall harm. This study aimed to increase our understanding of how such risks are generated in the lives of people who inject drugs. Methods: In 2022–2023, we interviewed 32 purposively selected research participants, primarily recruited through the Stockholm NSP. Drawing on actor-network theory, we analyzed the interviews to identify factors—constituent human and non-human actors—that constitute and generate risk and harm. These dynamics were conceptualized as risk-amplifying loops, in which harms are contingently enacted, may multiply, and the effects of policy and practice may become unintentional and unpredictable. Results: Four risk-amplifying loops were inductively elucidated: the Service deficit, Perpetrator-victim, Deprivation, and Solitude loops. In each, two actors—the drug and the person who injects drugs—were constituted differently. Furthermore, the loops were interlinked and more fully understood in relation to one another, forming a network that reflected the broader environment of injection drug use (IDU) in Sweden. Each loop was shaped and co-constituted by the prohibitionist framing of Swedish drug policy influencing access to services, the drug market, and the position of people who use drugs. Conclusions: Understanding drug-related harms as risk-amplifying loops highlights the emergent effects of the multiple and unfolding risks in the lives of people who inject drugs. This perspective facilitates discussion of impediments to effective harm reduction practices and points to potential sites for countermeasures and policy reform.

The comorbidity between problem gambling and substance use/abuse is high in many populations previously studied. However, the occurrence of problem gambling among individuals with substance abuse has not been thoroughly studied, which is especially true for individuals in inpatient or compulsory care. The present early-stage study explored the presence of gambling and problem gambling among inpatients in compulsory care in Sweden who has been court-ordered to treatment for their substance abuse (alcohol and/or drugs). The study furthermore investigates the use of preventive measures and treatment seeking. The most effective strategy to recruit participants (no incentive, incentive and incentive and face-to-face recruitment) was also explored. Twenty-one participants were recruited and seven of them had at-risk or problem gambling and none of them had accessed treatment. The best way of recruiting was to offer a gift certificate and inform about the study face-to-face. The implications are that individuals in compulsory care for substance abuse need to be screened for problem gambling, that recruitment for studies in this population is best carried out by offering incentives and educational efforts and that it might be beneficial for the clients in compulsory care to be offered gambling treatment. 

This study analyzes how emerging adults negotiate their relation to alcohol in the context of declining youth drinking and how this relationship changes over time. The sample consists of longitudinal qualitative interview data (N = 28) with 9 boys and 19 girls aged 15 to 21. The participants were recruited through schools, social media and non-governmental organizations from mainly the Stockholm region and smaller towns in central Sweden to reach a heterogeneous sample in terms of sociodemographic factors and drinking practices. We interviewed the participants in-depth three times between 2017 and 2019. Thematic coding of the whole data with NVivo helped us select four cases for more detailed analysis, as they represented the typical trajectories and showed the variation in the material. We used the master narrative framework and Bamberg’s narrative positioning analysis to examine the data. The analysis demonstrates what kinds of narrative alignments in identity development encourage heavy drinking, moderate alcohol consumption, and fuel abstinence. The results suggest that the decline in youth drinking is produced by a co-effect of multiple master narratives that intersect and guide the identity development away from heavy drinking.

It has been suggested that a pivotal explanation for the drastic decrease in young people’s alcohol consumption is the younger generations concern with taking responsibility for a variety of areas in their lives. Emanating from this, the overall aim of this article is to consider how alcohol and drinking situations are enacted among a group of emerging adults in Sweden from this ‘generation sensible’, and how they describe the relation between alcohol, pleasure and control. The study is based on 23 qualitative interviews with people aged 19–23. Inspired by assemblage theory we analyzed how important human and non-human elements congregate in described drinking situations. The analysis showed that alcohol is enacted as a strong psychoactive substance and described like other (illegal) drugs, rather than being seen as more harmless and acceptable. Pleasure in drinking is made possible through control and planning, and in downplaying the importance of drinking and the transgressive power of intoxication. We suggest that the risk-taking element in drinking is stigmatized among groups of emerging adults. It is concluded that while alcohol is described as unimportant to several participants, alcohol assemblages are not, therefore participants work hard to shape drinking situations to counteract loss of control.